Bring a large pot of water to a boil. Cook orecchiette according to package directions. Drain and set aside.
In a large cast iron skillet, heat 3 tablespoons olive oil to medium. Add sausage and cook until slightly browned, about 3 minutes, stirring to break up the sausage. Stir in Brussels sprouts and cook 4-5 minutes.
Stir in spinach and riced broccoli and cook 3-4 minutes, until spinach is wilted and sausage is completely browned. Stir in garlic, oregano, salt, pepper and crushed red pepper flakes.
Stir in cooked orecchiette and remaining 3 tablespoons olive oil. Taste and adjust seasoning, if necessary.
Serve with freshly grated or shaved Parmesan cheese.