First of all, excuse my poor English. I'm from Spain, and trying to do my best explaining this, and to "translate" from my Spanish OS to what it should say in English.
Anyway, YES, I think you must use modded drivers to get SLI hack working on Vista x64. At least I did that way. This is what I did (for Vista x64):
Step 1 Disable UAC, if not already disabled.
Step 2 Download
SLI String Installer v1.81 and unpack in to folder on HDD. Run slistringinstall.exe.
Step 3 Press ASUS, regardless of real motherboard, to patch Windows registry with SLIC certificate
Step 4 Download and install
ORIGINAL Forceware drivers v190.62. Reboot. (The link given is for US original v190.62. If you want any other language, choose it
here and then download
v190.62 drivers for that language)
Step 5 Replace original "nvlddmkm.sys" file with
modded one. Original one should be at "C:\Windows\System32\Drivers\" folder. (Remember to first make a backup of the original one!!!)
Step 6 Download and run
Driver Signature Enforcement Overrider 1.3b. Choose "Sign a system file" and give the path to the modded "nvlddmkm.sys" file (it should be "C:\Windows\System32\Drivers\nvlddmkm.sys"). If you already don't have your system into Test Mode, you can also use this tool to enable it.
Step 7 Once the Dseo13b.exe tool says "The system file has been signed successfully", reboot again.
Step 8 At restart, you should see a message saying something like "SLI compatible system". You can go now to nVidia Control Panel and under "Set SLI and PhysX Configuration", activate SLI.
Step 9 Enjoy.
Hope it helps. I think I didn't forget anything I did to get it working. Sorry for my English.