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Bring a pot of salted water up to a boil and cook pasta according to package instructions.
In a pan over medium heat add olive oil and sausage. Be sure to remove casing if you got sausage links.
Break up the sausage while cooking until browned.
Add in grated garlic and cook for 30 seconds.
Add in flour and stir until all the bits of flour aren’t visible.
Pour in your wine, if you want to omit this you can substitute for more cooking water from your pasta! The wine will loosen the brown bits on the bottom of your pan. Scrape the pan because the brown bits add FLAVOR. Turn heat to low.
Carefully add in your water reserved from the pasta water. Stir. A thick sauce will form.
Slowly add in heavy cream while mixing. Once all cream is mixed in, add in romano cheese. You can substitute romano for parmesan, but as always I prefer the stronger taste of romano!
Add in your spinach, seasonings and stir. Use your discretion for the red pepper flakes. They are spicy so go easy.
Add your drained pasta and stir with the heat still on. After about 30 seconds shut the heat. You may need to add in a little more cooking water from the pasta if your sauce is on the thicker side. If you decide to do that add ¼ cup of the water at a time until the desired consistency is met.
Serve immediately with more romano on top.