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Heat olive oil in a 12-inch skillet over medium heat. When the oil is very hot, add the onions. Squeeze the sausage from the end of the link to remove it from its casing and add directly into the pan. Use a spatula to break up the sausage into bite-sized pieces. Increase heat to medium-high and cook, stirring occasionally, until the sausage is browned. Reduce heat to low, then add the garlic and stir until fragrant, about 30 seconds.
Add broth, tomatoes, cream, and tortellini to the skillet. Stir to combine. Increase heat and bring to a boil.
Cover, then reduce the heat and simmer for 15 minutes until tortellini are tender and heated through. Taste the sauce and add plenty of salt and pepper to taste. I used 1 teaspoon of salt and ½ teaspoon of pepper. Add spinach and stir until softened and wilted. Remove from heat and serve