Long after the disgraced doctor is locked up in a federal prison, investigations into his misconduct will go on, perhaps for years.
"We have taken care of one perpetrator. We have not taken care of the systems that allowed him to flourish," said Rachael Denhollander, who filed a police report in 2016 about how Nassar had molested her 16 years earlier, when she was 15, with her mother in the room.
Before serving his two state terms, the 54-year-old must first serve 60 years in federal prison for child pornography crimes.
An astonishing 250-plus women and girls gave statements in two Michigan courtrooms over 10 days of proceedings. The focus will soon shift to lawsuits and multiple probes of Nassar's actions and those of people around him when he worked for Michigan State University and USA Gymnastics, the sport's governing body.
The NCAA has signaled that it may investigate potential rules violations related to Nassar's crimes. The Education Department is reviewing how Michigan State handled complaints about Nassar. And Congress is investigating USA Gymnastics, the university and the committee.
Larissa Boyce and another teen gymnast in 1997 reported Nassar to Michigan State's then-gymnastics coach, but he was not investigated until 2004, when another teen filed a complaint with police. Even then, that report did not result in criminal charges.
Boyce said she hopes the university and USA Gymnastics will "show the world how Nassar's actions were missed, the mistakes that were made ... so that other people can take a look and make changes where they need to make changes so this never happens again."
Katie Black, a Michigan State student who said she was sexually assaulted by Nassar when she was younger, returned for the sentencing after speaking in court Friday.
"I feel almost a sense of closure and that this is all over and things are going to be taken care of," Black said. Nassar listened to 48 victims for two days last week and was almost attacked by a man whose three daughters said they were abused.
In a brief statement before he was sentenced, Nassar attempted to apologise.
"It's impossible to convey the breadth and depth of how sorry I am to each and every one," he said.
In all, some 265 women and girls have reported being molested by Nassar. Some of the cases date back to the 1990s.
The judge said the abuse "spans the country and the world," noting that she heard from participants not only in gymnastics but also soccer, figure skating, rowing, softball, cheerleading, wrestling, diving, dance, and track and field.
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