1. Shape the Italian sausage into bite-sized meatballs and sear them in a hot skillet until browned and cooked through. Remove and set aside, reserving the fat in the skillet.

2. Add the ground beef to the same skillet and cook until fully browned. Season with salt and pepper. Drain excess grease if needed.

3. In a separate saucepan, boil the bowtie pasta in salted water until al dente. Drain and set aside.

4. Add butter to the skillet with the ground beef. Stir in minced garlic and sauté until fragrant.

5. Add cream cheese to the garlic butter mixture and stir until smooth. Fold in mozzarella cheese to create a rich, creamy sauce.

6. Stir in the fresh spinach and let it wilt into the sauce.

7. Add the cooked pasta to the skillet, tossing it in the sauce until fully coated.

8. Return the sausage meatballs to the pan. Combine and let heat through.

9. Serve hot with optional extra cheese or fresh herbs.