Bring a large pot of salted water to a boil. Add the pasta and cook according to package instructions until al dente. Reserve about a cup of pasta water, then drain the pasta and set aside.
In a large skillet, heat 1 tablespoon of olive oil over medium heat. Add the sliced turkey sausage and cook until browned and cooked through, about 5-7 minutes. Remove the sausage from the skillet and set aside.
In the same skillet, add the remaining tablespoon of olive oil. Toss in the minced garlic and sauté until fragrant, about 30 seconds. Add the shrimp, season with salt, pepper, and red pepper flakes if using, and cook until pink and opaque, roughly 2-3 minutes per side.
Add the halved cherry tomatoes to the skillet and cook until they start to soften, about 2 minutes. Then, toss in the spinach leaves and cook until wilted, about another minute.
Return the cooked sausage to the skillet and stir to combine. Add the cooked pasta, tossing everything together. If the pasta seems dry, add reserved pasta water a little at a time until you reach your desired consistency.
Taste and adjust seasoning with salt and pepper. Garnish with fresh basil leaves and a generous sprinkle of grated Parmesan cheese. Serve immediately and enjoy!