I'm sure someone can post a technical definition, but my recollection from a former install (15 years ago) is that they're basically like a 4-wire E&M, and the PBX transmits 7-digits towards the CO. I seem to remember a limitation that you couldn't used the same set of cama trunks for multiple area codes.
In our environment (rolm 8000's)the PBX sent 4 digit extension to a Telident box on a TIE trunk, and the Telident box had a tie-to-CAMA transaltor. It prepended our exchange, and then sent the call on to the CO. We had a companion software product that we used to put a physical location to a DID. That software transmitted to a data center somewhere, which them merged the data into the PSAP's database.
That installation has subsequently been replaced with PRI trunks and gained improved functionality. They still have the software to do the DID-to-location update, but any trunk can be used for a 911 call, and every call provides location information, instead of being limited to the physical quantity of CAMA trunks. At that time they ran around $175/trunk, and we were required by state law to have at least two, so two trunks paid for a full PRI.
Does that answer the question? I know there were a couple of LEC's out there that don't have the correct e911 software in their CO's, so they can't use PRI for those calls. A shame really. I hope by now that has been corrected.