Combine sausage and breadcrumbs. Form into little meatballs, about 3/4 inch in diameter. Set aside.
Heat oil in dutch oven and saute onion, stirring, until tender, about 5 minutes. Add garlic and continue stirring for another minute. Add broth, water, 3/4 teaspoon of salt and 1/2 teaspoon black pepper. Bring to a boil, add meatballs and simmer 5-6 minutes. Add tortellini, basil, roasted red peppers, lemon juice and Italian seasoning and simmer until tortellini is tender. Stir in spinach, cover pot and remove from heat. Wait about 2 minutes until spinach is wilted. Spoon into soup bowls and sprinkle with cheese.