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Bring a pot of water to a boil.
Add pasta to the boiling water and cook according to package directions, or until al dente, stirring occasionally. Reserve 1 cup pasta water, then drain pasta and set aside.
Meanwhile, heat olive oil and add sausage in a skillet over medium heat. Cook until browned, about 4-5 minutes.
Reduce heat to medium-low add spinach and garlic and cook until softened, about 3-4 minutes.
Add zucchini and cook until tender. Salt and pepper to taste.
Add Parmesan. Stir to combine and cook until heated through, about 1 minute. Season to taste with salt and pepper.