Spread about 3 tablespoons of the cream cheese to within 1-inch of the edge of a tortilla. Layer with some of the spinach leaves, tomato slices, pepperoni, and 1/2 cup of the cheese. Tightly roll up into a spiral. Repeat with remaining ingredients.
To serve, transfer to a cutting board. Slice off and discard ends. Cut rolls into 1-inch slices. Secure with wooden toothpicks. Stack three or four spirals, slightly off center, to appear as a spinal column.
Prepare as directed except do not cut into 1-inch slices. Wrap and refrigerate for up to 24 hours. Slice before serving. Makes 24.