In a Dutch oven or large pot, brown sausage until cooked through, coarsely breaking apart as you brown it. Drain the oil.
Add diced onion and cook for a minute or 2 until tender.
Add in water and broth and bring to a boil. Reduce heat, and let simmer for 5-10 mins.
Return to a boil and add in tortellini. Cook for 7-10 mins or until tortellini is tender.
Stir in spinach leaves. Stir to wilt.
Serve in bowl and top with shredded parmesan cheese. Enjoy!