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Bring a large pot of water to a boil. Cook pasta according to package directions. Drain, reserving ¼ cup cooking water.
Meanwhile, heat 2 tablespoons oil in a large nonstick skillet over medium-high heat. Add mushrooms; cook, stirring occasionally, until well-browned, about 10 minutes. Stir in garlic; cook, stirring constantly, until fragrant, about 30 seconds. Stir in spinach; cook, stirring constantly, until wilted, about 1 minute.
Reduce heat to medium-low; stir in balsamic vinegar, Worcestershire, salt, pepper and the remaining 2 tablespoons oil. Add the pasta and toss to coat. Stir in the reserved ¼ cup cooking water. Remove from heat. Stir in basil and sprinkle with pistachios.