Using a meat grinder with a medium grind, combine the pork and fatback and process into a bowl. Stir the salt, pepper, sage, cayenne, sugar, and water into the meat mixture and mix until completely incorporated. Form the sausage into patties. Cook the patties, in batches as needed, in a skillet over medium heat until browned on both sides and cooked through, about 4-6 minutes per side. Serve immediately or freeze for up to 3 months in an airtight container.