Most towers are connected physically to the public telephone network. When you make a call, the system determines whether the call can be carried more efficiently by bouncing it through other towers or carrying it to the recipient's tower through the wired network. I don't know for sure, but I'd guess any call that would pass through more than 3 or 4 towers would be carried more efficiently through wires.
1. Microwave backhaul- typically for rural or out of the way sites- a microwave link across multiple towers is set up and linked back to another tower that has access to the public landline system
2. T-1 or fiber - Most sites are connected to the landline system via traditional T-1 lines from the phone company or via fiber - this is what the previous answerer was referring to
3. Wireless backhaul- Relatively new- but companies are now offering wireless links via fixed point to point or point to multipoint systems. A small dish will be installed on the tower and relayed back to a central point wirelessly to be connected to the network via fiber. More common in urban areas and relatively new.