1. Heat a large nonstick skillet over medium heat. Add the Italian sausage and cook until browned, breaking it into bite-sized pieces. Remove using a slotted spoon and set aside, leaving the drippings in the pan.

2. Reduce the heat slightly. Add butter to the same skillet and let it melt. Stir in the minced garlic and sauté for about 1 minute until fragrant.

3. Pour in the heavy cream, stirring continuously to blend with the garlic butter. Let it simmer for 3–4 minutes to thicken slightly.

4. Add the cheese tortellini into the sauce. Let it simmer gently until tender if uncooked, or stir in cooked tortellini if using pre-boiled.

5. Sprinkle in the Italian seasoning, salt, and black pepper. Stir to combine evenly.

6. Return the cooked sausage to the skillet, then add the fresh spinach. Fold gently until the spinach wilts and everything is coated.

7. Stir in the Parmesan cheese and mix until melted and fully incorporated. Let rest off the heat for 2 minutes, then serve hot.