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Add the sausage meat and chopped onion to a skillet. Sauté for about 7 minutes. Add the garlic in towards the end so it doesn't burn. Spoon out most of the fat (you don't need to be precise... fat gives the soup more flavor). Add the sausage mixture to your Crockpot.
Meanwhile, chop your carrots and celery. Add all ingredients except for the tortellini, spinach, cream, and salt & pepper to the Crockpot. Keep in mind that if you want the soup to cook in 3-4 hours, the carrots will have to be chopped pretty finely. If you're cooking it for 7-8 on low or 4-5 hours on high, you can chop them larger.
About 30 minutes prior to serving, add in your cheese tortellini, cream, and spinach (I set the heat to "high"). Give it a stir occasionally. Season with salt & pepper as needed prior to serving.
Notes 1-21-24: Only used 12 oz of sausage but will add more next time. Also, up the cream to a full cup.