"How much is a little girl worth?" Rachael Denhollander asked in an Ingham County courtroom Wednesday, where once-renowned sports medicine doctor Larry Nassar was sentenced to prison for sexually assaulting her and at least 160 other little girls and young women under the guise of medical care.

"How much is a young woman worth?"

Judge Rosemarie Aquilina's answer: 40 years to 175 years in prison.

"I just signed your death warrant," Aquilina said.

Recap: Day 7 of Larry Nassar's sentencing hearing

Nassar, 54, of Holt plead guilty to seven counts of first-degree criminal sexual conduct in the case.

"Justice requires an action and a voice," Aquilina said, adding that the women who spoke in her courtroom were "168 buckets of water on your so-called match that got out of control.

"There has to be a massive investigation as to why there was inaction, why there was silence. Justice requires more than what I can do on this bench.

Transcript: What Larry Nassar said during his sentencing hearing

"Your decision to assault was precise, calculated, manipulative, devious, despicable. ... You can't give them back their innocence, their youth. You can't give a father back his life, or one of your victims back her life when she took it. You can't return the daughter to the mother, the father to the daughter. You played on everyone's vulnerability.

"It is my honor and privilege to sentence you, because sir you do not deserve to walk outside a prison ever again."

Nassar told the court and the victims filling the room before that sentencing that he is sorry.

"Your words these past several days, your words, your words, have had a significant emotional impact on myself and have shaken me to my core," he said, as sobs could be heard from the survivors in the courtroom. "There are no words that can describe the depth and breadth for how sorry I am for what has occurred.

"An acceptable apology to all of you is impossible to express or convey. I will carry your words with me for the rest of my days."

Mark Hollis: MSU 'will cooperate' with NCAA investigation into Nassar case

The sentence all but ensures Nassar — who was hailed as an elite doctor and given access to Olympic gymnasts at USA Gymnastics as well as athletes at Michigan State University and at private gyms for more than two decades — will spend the rest of his life in prison.

He was sentenced in December to 60 years in prison on three federal child pornography charges and faces sentencing later this month on three more sexual assault charges in Eaton County.

Denhollander, who was the first of Nassar's victims to come forward following an Indianapolis Star exposé about a sex-abuse scandal at USA Gymnastics, was the last of 156 women to testify over seven days in Ingham County Circuit Court.

"It took all of our voices to get here," she said.

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