In a large Dutch oven, brown sausage over medium heat. Remove and set aside.
Add carrot, onion, celery, and garlic to the pot. Sauté 5 minutes until softened. Stir in tomato paste, Calabrian peppers, flour, Italian seasoning, garlic powder, onion powder, salt, and pepper.
Pour in vodka and scrape up browned bits. Stir in chicken broth, vodka sauce, and Parmesan rind. Return sausage to pot. Simmer 15–20 minutes.
Add tortellini and cook according to package directions. Remove Parmesan rind.
Stir in cream and spinach until wilted.
Serve hot, topped with Parmesan.