In a large pot or Dutch oven over medium-high heat, brown the Italian sausage, breaking it into small crumbles until cooked through.

Remove excess fat, leaving about 1 tablespoon in the pot. Add the diced onion and sauté for 3-4 minutes until translucent.

Add the minced garlic, Italian seasoning, and red pepper flakes; cook for 1 minute until fragrant.

Pour in the chicken broth and crushed tomatoes. Bring the mixture to a boil.

Reduce heat to medium-low and add the cheese tortellini. Simmer for 7-9 minutes or until the tortellini is tender.

Stir in the heavy cream and fresh baby spinach. Heat for 2 minutes until the spinach is wilted.

Season with salt and pepper to taste. Serve warm garnished with parmesan cheese.