First, add sausage, onion and garlic to a large skillet and heat over medium heat, breaking apart sausage and mixing ingredients until sausage is browned.
Stir in pumpkin, sour cream, half and half and chicken broth. Then stir in the spices
.
Over medium low heat, bring to a boil and reduce heat to low, stirring occasionally heating for about 5 minutes.
Stir in pasta and spinach until spinach is wilted. Top with cheese and serve hot.
Notes
I used a 10" skillet, but it was a rather tight squeeze. If you want less of an opportunity to spill and make a mess, maybe try a large pan/stockpot.