I played with this two weeks ago, it's very simple. The only problem is that all the tutorials just talk about saving the image locally. This is how I did it:
1) I set up a form so I can use a POST method.
2) When the user is done drawing, he can click the "Save" button.
3) When the button is clicked I take the image data and put it into a hidden field. After that I submit the form.
document.getElementById('my_hidden').value = canvas.toDataURL('image/png');
document.forms["form1"].submit();
4) When the form is submited I have this small php script:
<?php
$upload_dir = somehow_get_upload_dir(); //implement this function yourself
$img = $_POST['my_hidden'];
$img = str_replace('data:image/png;base64,', '', $img);
$img = str_replace(' ', '+', $img);
$data = base64_decode($img);
$file = $upload_dir."image_name.png";
$success = file_put_contents($file, $data);
header('Location: '.$_POST['return_url']);
?>