Correct. The single PCI slot on the Mini-ITX boards are actually wired so that you can break them out into two seperate slots, but no more. This riser card has a PCI to PCI bridge on it that puts another PCI bus in the machine and the new bus has three PCI slots on it.
Problem is they are still going the wrong direction for you.. away from the motherboard, not back over it. You'd still need a PCI extender to flip the thing over...
Also, since this is over a PCI bridge, I'm not sure if the BIOS will like a video card in here.. Windows/Linux might be able to get it to recognize/work, but even still, your performance may suffer a bit.. You'd just have to try to be sure