Objective: To compare the efficacy and safety profiles of posterior spinal dynamic correction (PSDC) versus posterior spinal fusion (PSF) in treating Lenke Type 5 adolescent idiopathic scoliosis (AIS) patients. Methods: This retrospective comparative study reviewed 38 patients: 13 who underwent PSDC and 25 who underwent PSF. Inclusion criteria included a primary thoracolumbar/lumbar curve of 35° to 65°, Risser stage ≥3, and age of 12 to 18 years. The mean follow-up was 2 years. Radiographic parameters, perioperative data, and complications were compared. Results: The groups were comparable regarding all preoperative demographic and radiographic measures (p > 0.05). The mean main curve correction was not significantly different between the PSDC and PSF groups, either immediately postoperatively (PSDC: 85.5%±8.9; PSF: 82.5%±10.7, P=0.465) or at the final follow-up (PSDC: 80.3%±11.5; PSF: 75.8%±15.4, P=0.564). At the final follow-up, the PSDC group maintained segmental motion at the instrumented levels (sagittal, 4.8° ± 2.3°; coronal, 13.1° ± 6.9°). Compared with the PSF group, the PSDC group had a longer operative time (273.2±36.9 min vs 202.5±43.7 min, p<0.01) but significantly less estimated blood loss (150±66.3 mL vs 282±120.7 mL, p<0.01), fewer instrumented levels (5.5±0.5 vs 6.6±0.8, p<0.01), and a shorter time to first ambulation (4.3±1.0 day vs 7.7±1.4 days, p<0.01). No major complications or revision surgeries occurred in either group. Conclusion: For select patients with Lenke Type 5 AIS, PSDC provides deformity correction comparable to that of traditional PSF, while offering the advantages of preserved partial segmental motion, reduced blood loss, and accelerated postoperative recovery.