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Preheat oven to 400°F. In a large mixing bowl, combine all meatball ingredients except olive oil spray. Mix gently until combined.
Roll into 1½-inch golf balls and place in a single layer on a greased baking sheet. Spray with olive oil spray and bake for 25–30 minutes, or until the internal temperature reaches 165°F. Broil for 3–4 minutes at the end if needed for golden brown tops.
While meatballs bake, heat olive oil in a large skillet over medium heat. Add grated garlic and red pepper flakes and cook for 3 minutes until fragrant. Stir in uncooked orzo and broth, bring to a simmer, cover, and cook for 9–10 minutes.
Remove lid and add spinach and heavy cream. Cover and cook another 3 minutes until spinach wilts.
Stir in cheese, lemon zest, and lemon juice. Season with salt and pepper.
Pour orzo into a shallow serving bowl, top with meatballs, drizzle with olive oil, and add extra grated parmesan cheese.