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Boil salted water and cook fettuccine according to package directions.
Reserve ½ cup of pasta water, then drain and set aside.
If using a raw lobster tail, steam or boil until opaque (about 5–6 minutes), then remove the meat and chop it.
If pre-cooked, just chop into bite-size pieces.
In a large skillet over medium heat, melt the butter.
Add garlic and sauté until fragrant (30 seconds).
Pour in heavy cream, stir, and let it gently simmer for 2–3 minutes.
Whisk in Parmesan cheese until the sauce thickens and becomes smooth.
Stir in lobster meat and chopped spinach.
Cook until the spinach wilts and the lobster is heated through (1–2 minutes).
Add the cooked pasta to the skillet and toss to coat.
Add a splash of reserved pasta water if the sauce is too thick.
Season with salt, pepper, and optional nutmeg or red pepper flakes.