Can someone more knowledge about this condition shed some light on it for me?
Is it something they are born with or can it develop over time? If you X-ray their backs at a young age, between 2-4 let’s say, and the rads are clean, is there still a chance they develop it later in life?
Is it genetic? If a horse has a full sibling with the condition, is it more likely that the other one will develop it as well?
As I understand it, ks is a form of osteoarthritis so all the unpredictability of arthritis progression applies to ks.
I have a homebred who was just green broke last spring (2023) at 4, has had very minimal light work until March 2024 , when an investigation. Into some sudden grumpiness revealed possible kissing spine. So no guarantees.
So the answers to these questions are mostly: we don’t know. 
there really isn’t a lot of good scientific understanding of the condition(s) and what may cause it!
Essentially, “kissing spines” is suspected to be genetic by a lot of people. However, KS seems to be tied to conformation - certain back shapes - which are also genetic. Whether it’s the KS or the propensity that’s genetic, we don’t know.
Some suspect that a lot of KS can be attributed to poor posture and work, poor farriery, poor management, etc. KS horses are often (IME) particularly sensitive to these things - for example, some can be happy in work if the saddle is perfect and they’re never in a stall and their hoof angles are ideal. Whether this sensitivity is the cause of the KS or a result of it is unclear.
I think @endlessclimb has a mare that showed borderline or close processes on PPE that have resolved with proper work. I know a couple horses that were clear on PPE but have radiographic proof of KS found later.
It is worth noting that the horse’s posture + skill of the person taking the X-rays + angle of the X-rays + machine can all add up to wild variations in “KS or no KS” on the same horse at the same time. Especially for milder cases that don’t have tons of remodeling.
Essentially, we don’t know. We can’t test for it, can’t really tell the difference between inherent KS vs KS as a result of bad riding, and the term “kissing spines” can cover a whole range of conditions from the very mild to crippling severe.
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