Cooking the Sausage: Add the Italian sausage to a soup pot or Dutch oven. Cook over medium-high heat for about 5 minutes, breaking it apart as it cooks.

Adding Onions: Stir in the chopped onions and continue cooking for another 5 minutes, until the sausage is nicely browned and the onions have softened.

Infusing Flavors: Add the minced garlic, crushed red pepper flakes, and orzo to the pot. Cook for an additional 30 seconds to let the garlic release its aroma.

Adding Liquids: Pour in the chicken broth and cream. Once the mixture starts to bubble, reduce heat to medium or medium-low to maintain a gentle simmer. Continue cooking for 10 minutes, stirring often to prevent the orzo from sticking.

Finishing Touches: Remove the pot from the heat, then stir in the grated Parmesan and fresh spinach. Cover the pot and let it sit for 3-5 minutes until the spinach is wilted and the sauce has thickened to your liking. Season with salt and pepper.