In a large skillet, heat olive oil over medium high heat. Add the onion and cook until softened, about 5 minutes. Stir in the garlic and cook for 1 minute, until fragrant.
Add the sausage and cook 5 minutes until no longer pink.
Stir in pumpkin puree, cinnamon, nutmeg, all spice, and fresh sage. Cook for 1 minute, stirring frequently.
Add wine to the skillet. Cook 1 minute, stirring frequently and scraping up any browned bits on the bottom of the pan.
Distribute conchiglie pasta evenly in the skillet. Pour milk and broth over the pasta. Bring to a simmer. Cover and cook until pasta is al dente, about 9-10 minutes.
Remove from heat. Stir in parmesan cheese, chopped spinach, chili pepper flakes and salt and pepper to taste. Garnish with parsley. Serve immediately.
