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Brown the sliced andouille sausage in olive oil until golden and caramelized. Remove and set aside.
Add the cherry tomatoes to the same pan and cook until blistered and starting to burst.
Add butter and diced onion. Cook until softened, then add garlic and cook for another 30 seconds.
Add Italian seasoning, smoked paprika and Cajun seasoning, if using.
Pour in the chicken broth and heavy cream, scraping up all the flavorful browned bits from the bottom of the pan.
Add the tortellini and simmer according to the package directions, stirring occasionally.
Stir in Parmesan, spinach and the browned sausage. Cook until the spinach wilts and the sauce is creamy.
Finish with freshly cracked black pepper and a squeeze of lemon juice if desired.